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Asian Journal of Urology, 2018, 5(4): 287-294    doi: 10.1016/j.ajur.2018.08.004
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Present indications and techniques of percutaneous nephrolithotomy: What the future holds?
Itay M. Sabler(),Ioannis Katafigiotis,Ofer N. Gofrit,Mordechai Duvdevani
Department of Urology, Hadassah Hebrew University Hospital, Ein Karem, Jerusalem, Israel
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Abstract: 

The purpose of the review was to present the latest updates on percutaneous nephrolithotomy (PCNL) procedure in terms of indications and evolving techniques, and to identify the advantages and disadvantages of each modality. The data for this review were collected after a thorough PubMed search in core clinical journals in English language. The key words included “PCNL” and “PNL” in combination with “indications”, “techniques”, “review” and “miniaturized PCNL”. Publications relevant to the subject were retrieved and critically reviewed. Current European and American Urology Association Nephrolithiasis Guidelines were included as well. The indications for standard PCNL have been changed through the past decade. Despite evolution of the procedure, innovations and the development of new technical approaches, the indications for miniaturized PCNL have not been standardized yet. There is a need for well-constructed randomized trials to explore the indications, complications and results for each evolving approach. A continuous reduction of tract size is not the only revolution of the last years. There is constant ongoing interest in developing new efficient miniature instruments, intracorporeal lithotripters and sophisticated tract creation methods. We can summarize that, PCNL represents a valuable well-known tool in the field of endourology. We should be open minded to future changes in surgical approaches and technological improvements.
Key words:  Percutaneousnephrolithotomy    Nephrolithiasis    Intracorporeallithotripsy    Lasers    Tract creation    Renal access    Horseshoe kidney    Calycealdiverticulum    Lower pole stones
收稿日期:  2018-01-01      修回日期:  2018-04-10      接受日期:  2018-05-25      出版日期:  2018-10-20      发布日期:  2018-11-19      整期出版日期:  2018-10-20
引用本文:    
. [J]. Asian Journal of Urology, 2018, 5(4): 287-294.
Itay M. Sabler,Ioannis Katafigiotis,Ofer N. Gofrit,Mordechai Duvdevani. Present indications and techniques of percutaneous nephrolithotomy: What the future holds?. Asian Journal of Urology, 2018, 5(4): 287-294.
链接本文:  
http://www.ajurology.com/CN/10.1016/j.ajur.2018.08.004  或          http://www.ajurology.com/CN/Y2018/V5/I4/287
Study Type of study Levels of evidence Number of patients Objective of the study
Kruck et al. [2] Retrospective 3b 482 Mini-PCNL
De et al. [3] Meta-analysis 1a 727 PCNL, mini-PCNL, micro-PCNL
Kirac et al. [4] Retrospective 3b 37 Mini-PCNL
Prakash et al. [11] Retrospective 3b 86 PCNL
Purkait et al. [13] Retrospective 3b 44 PCNL
Waingankar et al. [17] Review 4 221 PCNL
Srivastava et al. [18] Retrospective 3b 44 PCNL
Gücük and üyetürk [19] Review 4 259 PCNL
Zhang et al. [20] Meta-analysis 1a 2142 PCNL
Siev et al. [22] Retrospective 3b 101 PCNL
Yuan et al. [24] Meta-analysis 1a 6881 PCNL
Derisavifard et al. [26] Review 4 NA PCNL
Hatipoglu et al. [29] Retrospective 3b 200 PCNL
Sharma et al. [30] Review 4 NA Access technique
Sorensen et al. [31] Prospective 3b 18 Ultrasound detection
Li et al. [32] Prospective 3b NA Access technique
Rodrigues et al. [33] Review 4 NA Puncture technique
Isac et al. [35] Retrospective 3b 159 Access technique
Ritter et al. [39] Prospective 3b 27 Puncture technique
Tepeler et al. [42] Prospective 3b 20 Microperc, PCNL
Gao et al. [43] Meta-analysis 1a 1279 Mini-PCNL, ultramini-PCNL, micro-PCNL
Ruhayel et al. [44] Systematic review 3a NA Mini-PCNL, PCNL
Schilling et al. [45] Review 4 NA Nomenclature proposal
Sabnis et al. [46] Randomized controlled trial 2b 35 Microperc
Wang et al. [47] Retrospective 3b 216 Mini-PCNL, PCNL
York et al. [51] Randomized controlled trial 2b 201 PCNL
El-Nahas et al. [50] Randomized controlled trial 2b 70 PCNL
Table 1  Characteristics of studies included in the review.
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